inspire annual report 2014 - 2015 (updated 2016.01.12)

INSPIRE Network Report 2014-2015

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International Network for Simulation-based Pediatric Innovation, Research and Education

INSPIRE NETWORK REPORT 2014-2015

Mission & Vision Mission: To improve the delivery of medical care to acutely ill children and ultimately improve survival from acute illness in the pediatric population. Vision: To bring together all individuals working in pediatric simulation-based research to shape and mold the future of pediatric simulation research by answering important questions pertaining to resuscitation, technical skills, behavioral skills, debriefing and simulation-based education. History The INSPIRE Network is the International Network for Simulation-based Pediatric Innovation, Research, and Education. INSPIRE was formed in 2011 from a large group of pediatric simulation-based researchers from a variety of disciplines and specialties looking to improve collaboration, mentorship, and productivity. We merged two large-scale existing pediatric simulation research networks, EXPRESS and POISE, into INSPIRE in 2011. Organizational Structure This process has brought down the walls between institutions through shared resources and a mutual understanding of each other’s work towards a common goal. Our work has helped synergize ongoing projects in overlapping domains. We are not a formal academic society; rather, we are a bottom-up, grassroots organization that has formed to meet the needs of the rapidly changing landscape of pediatric simulation research. The network has been extremely productive in advancing and guiding simulation-based research activities. We provide a structure and process of mentorship to junior investigators. Resources to our members include an online database of ongoing studies and investigators, access to a research coordinator, librarian and statistician, online data sharing infrastructure (video, survey, database management) and a manuscript oversight committee for pre-publication review. INSPIRE is led by a diverse and inter-professional executive committee from institutions across the globe: Co-chairs Adam Cheng MD, Alberta Children’s Hospital, Canada Marc Auerbach MD, MSc, Yale University, USA Research chair David Kessler MD, MSc, Columbia University, USA International chair Ralph Mackinnon MD, Royal Manchester Children’s Hospital, UK Technology chairs Todd Chang MD, Children’s Hospital of LA, USA Jordan Duval-Arnould, Johns Hopkins University, USA

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Manuscript Oversight Committee chair Vinay Nadkarni MD, Children’s Hospital of Philadelphia, USA Senior co-chairs Elizabeth Hunt MD, PhD, Johns Hopkins University, USA Martin Pusic MD, PhD, New York University School of Medicine, USA

INSPIRE Network Membership

Members 580 Sites 214 Countries 31

Research Process and Network Support Structure Investigators are encouraged to begin their work by (1) submitting an ALERT presentation that is a brief description of their idea. Next, (2) the investigator is paired with a mentor and provided the “lay of the land” of ongoing research in that area to promote collaboration across projects. The investigator then conducts a (3) systematic review of the literature and plans an initial pilot study. The (4) pilot study methods are reviewed by the INSPIRE executive and shared with the network to recruit collaborators for a subsequent collaborative study. (5) The executive helps to facilitate multicenter studies with IRB templates, scope of work templates, data use agreements, collaborative oversight and clear expectations from the start. INSPIRE can also provide specialty consultation with leading experts in biostatistics, educational research, technology and psychometrics. When the team has completed their work, (6) the manuscript oversight committee provides a pre-review of the work product and guidance on submission for publication. Additionally, (7) for selected projects the executive helps to provide letters of support for grant submission. In exchange for this support the INSPIRE investigator provides acknowledgement of INSPIRE in any presentation/publication and support for the INSPIRE administration on grants. See Figure for details.

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Figure: INSPIRE Research Process and Network Support Structure

Young

Investigator with Research

Idea

•Online Research Series •Senior INSPIRE mentor (via online mentor match) to help with establishing research goals and development of 1 page

“specific aims” page

Systematic Review or

Needs Assessment

•INSPIRE Research Coordinator to assist with methodology for systematic review •INSPIRE Librarian to assist with literature search

Pilot Study

•Review and revise study protocol with INSPIRE mentor •Review study protocol with INSPIRE technology director to discuss possible tech-assisted outcome measures •Review with INSPIRE statistical consultant to solidify analysis plan, feasibility, and power analysis

Multicenter

Study

•INSPIRE scientific committee to review protocol and grant proposal •INSPIRE website to assist in finding collaborators and recruitment sites •INSPIRE research portal for data collection •Data analysis and submission to Manuscript Oversight Committee (MOC)

Knowledge Translation

•INSPIRE research assistant and graphic designer to assist with poster preparation •INSPIRE writing group and scientific committee to assist with review of manuscripts and mitigation of authorship issues

and byline •Submission of manuscript for peer review, amend with mentor and writing group, publish

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INSPIRE Research Themes INSPIRE has conducted a series of consensus conferences to identify themes of inquiry within pediatric simulation (Tables). This framework will guide our networks focus over the next five years.

Training and Assessment Debriefing Develop/assess/implement effective techniques for debriefing real/sim events IPE, Teamwork, Communication Develop/assess/implement effective techniques for team training

Procedural, Psychomotor Skills Develop/assess/implement effective techniques for skills development retention

Innovation and Technology

Technology Develop/assess/implement novel technologies to improve processes of care and pediatric outcomes

Acute Care and Resuscitation

Develop/assess/implement novel techniques for improving care of pediatric patients

Human Factors Assess the roles of human factors when providing care to pediatric patients

Patient Safety Explore the key variables that influence patient safety and assess strategies to mitigate

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New INSPIRE Projects Presented in 2015

Project Lead Investigator

Lead Institution Description Current Status

The use of Leaderboards & Competition to improve self-initiated CPR training

T. Chang Children’s Hospital Los Angeles

International, multi-institutional randomized control-crossover study examining the effect of a competitive leaderboard on usage frequency and performance on simulated CPR skills.

Have funding from AHA for 2 years. In IRB & Recruitment phase as of July 2015.

Resuscitating Teamwork and Safety Using Acute Event Debriefing

M. Moga Ann & Robert H. Lurie Children’s Hospital of Chicago

Nurse-led, acute event debriefing for patients suffering cardiac arrest in the ICU.

In development.

The effect of summative feedback on the accuracy of provider perceptions and the quality of CPR during a simulated pediatric cardiac arrest

L. Brown University/ Hasbro Children’s Hospital

CPR certified healthcare providers; 1) summative feedback re: quality of CPR; 2) HCP with no summative feedback. Test improved quality of CPR and improved accuracy of HCP perceptions.

In development.

The use of Leaderboards & Competition to improve High School CPR training

R. MacKinnon Royal Manchester Children’s Hospital

Examining the effect of a competitive leaderboard on usage frequency and performance on simulated CPR skills in highschools.

Recruiting sites.

Integrating Cognitive Aids (INCA)

D. Bould Children’s Hospital of Eastern Ontario, University of Ottawa

Use of knowledge-based cognitive aids in interprofessional teams.

PSI funding received.

Pediatric Simulation in Rural India: PedSRI Study

S. Thyagarajan

PediSTARS India

Develop a structured Simulation training program to address recognition, stabilization and transfer to a higher centre & study the impact on patient outcomes.

In development.

NRP eSimulation A. Ades Children’s Hospital of Philadelphia

Comparison of eSim to video review to no training after initial NRP course for enhancing retention at 6 months.

Finalizing study population & intervention arm.

Measurement of Stress Levels in Simulation and the Impact of Stress on Performance: Announced Versus Unannounced Simulation Based Training

S. Lyons Bristol Medical Simulation Centre

Measuring Impacts of stress on performance, and physiological and biochemical changes associated with the stress response using announced versus unannounced simulation based training.

In development.

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Development of a Pediatric Simulation Curriculum and Database Collaborative

T. Stavroudis

Children’s Hospital Los Angeles

To form a pediatric simulation curriculum collaborative to establish a core group of educators and simulationists to build a credentialed, centralized pediatric simulation scenario platform and database that utilizes the ABP Board Content Specifications and ACGME Core Competencies and Developmental Milestones as the core principles of the curriculum.

Establishing infrastructure and identifying grant sources.

Script Assisted Feedback to Educate (SAFE Tool)

E. Sigalet Sidra Research and Medical Center

Testing the SAFE tool to support debriefers in using a structured approach with all forms of feedback to optimize learning.

Research design in development.

Improving the quality of team training and performance during interprofessional in situ mock code blue simulations: A randomized controlled mixed-methods study

C. Walsh Hospital for Sick Children

Comparing just in time training to no training for interprofessional teams in mock in-situ code blue simulations.

IRB Complete. Funded. Starting recruitment phase.

INSPIRE Projects Presented In 2014 (Ongoing / Completed)



Improving Basic Life Support and Outcomes from Cardiac Arrest: Implementation and Evaluation of the American Heart Association’s Resuscitation Quality Indicator (RQI) CPR Training Program

A. Cheng Alberta Children’s Hospital

The objective of this study is to evaluate the effectiveness of the AHA’s RQI program when compared with traditional annual BLS recertification (for pediatric healthcare providers).

Ethics received. Starting recruitment.

Development of simulation-based assessment tools for the general pediatrics milestones

L. Mallory Maine Medical Center

Will use a modified Delphi method with group of pediatric simulation experts and program directors to identify priority areas for simulation-based assessment aligned with the ACGME Next Accreditation System Pediatric Specialty Milestones.

Survey phase complete. Developing assessment tools in 3 prioritized areas. Manuscript preparation.

Use of Simulation in Limited Resource Countries. How can it be done?

D. Moro-Sutherland

Texas Children’s Hospital

Two projects have come out of the original presentation during the INSPIRE meeting at IMSH 2014.

1. Low cost sim repository housed b/w

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1. Education through low-cost simulation in the global health arena 2. Use of Simulation in Limited Resource Countries: How can it be done?

Open Pediatrics & IPSS. 2. Low cost sim cases written. Pilot in Feb 2016. Incorporate sim into curriculum by summer 2016.

Handheld High Fidelity Simulation Training For IV Catheterization

D. Weiner M. Ottensmeyer

Boston Children’s Hospital/Harvard Medical School

Build/use handheld high fidelity haptic simulation training device to teach PIV catheterization anywhere, anytime independent of infrastructure. Plan to compare to traditional methods of learning i.e. IV arm, instructor.

INSPIRE multicenter study in planning stage.

The effect of random leader role assignment on task and team performance during CPR

S. Ambati Cohen Children’s Medical Center of NY, NSLIJ

The main aim of this project is to show pre-designated leader role will improve team performance and to see whether physician or the nurse in the leader role will make a difference. Intervention- groups that has pre-designated leader role. Control – No leader role.

Recruitment in progress.

A Virtual Pediatric Simulator (VPS) For Emergency Scenario Training of Military Medical Personnel

J. Gerard A. Scalzo

Saint Louis University

Project funded by the ONR to develop a game-based virtual reality simulator for training on high-stakes pediatric emergency medicine scenarios.

Scenarios in development. User testing and validation study in summer 2015.

Resuscitation Review to Guide Educational Interventions

A. Ruscica D. Kessler

Morgan Stanley Children’s Hospital, Columbia University, New York

Pediatric Emergency medicine practitioners will identify a variety of key points learned or reviewed during resuscitations they have been involved in. These key points identified during resuscitations will be areas that the rest of the pediatric emergency staff would like more education on and identify as low self-efficacy topics.

Final phase of data collection.

Improving realism of PALS-courses with smart simulation tools & children

W. Burkhard et al

PSRCS Pediatric Simulation Research Collab. Southtyrol

Currently only use BLS and ALS mannequins during PALS courses. Introduce tablet patient monitors an all PALS stations. Use of real sound sequences on 2 of 3 practical stations comparing learning

Research protocol in development.

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outcomes of students in differently equipped teaching stations. Integration of real children. Change of skin color.

Simulation using the PECARN Head Trauma Rule to Reduce CT Imaging

K. Ching New York Presbyterian Hospital - Weill Cornell Medical Center, Mount Sinai Hospital

Limiting unnecessary CT scans for children with head trauma. PECARN clinical prediction rule helps identify children with very low risk for TBI( Traumatic Brain Injury). Objective of this trial is to develop a pediatric simulation exercise illustrating the use of the PECARN clinical prediction rule.

Second year of pilot study is complete. Now enrolling subjects for multi-center prospective randomized control educational intervention study involving 6 sites.




of the Project Learning Retention and the Timing of Refresher Education After the Deliberate Practice of Radiograph Interpretation

Martin Pusic Kathy Boutis

New york University, University of Toronto

Deliberate practice on cognitive simulators produces reliable individualized learning. Rates of retention and need for refreshers is difficult to predict. This RCT uses the learning of radiograph interpretation to develop a framework for “forgetting curves”.

Phase 1 completed; recruitment underway for Phase 2.

Exploring the Facilitators and Barriers to Implementing Simulation-based Competency Assessments to Determine Trainees' Readiness for the Infant Lumbar Puncture (LP) Procedure

Julie Pasternack Ryan McBeth Rita Dadiz

University of Rochester

To determine the factors that increase or decrease the likelihood that sites participating in the lumbar puncture study would achieve greater compliance with their interns performing competency assessments prior to their first LP.

In Manuscript preparation.

Rapid Cycle Deliberate Practice for Resuscitation Teams

Daniel Lemke Cara Doughty


Fast-paced deliberate practice model to train residents in resuscitation management over short, but frequent exercises. It also aims at comparing the traditional and RCDP techniques.

Published RCDP curriculum for residents. In Manuscript preparation.

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Simulation to teach management of tracheostomy emergencies for new parents

Jennifer Arnold Shilpa Hundalani


PepTALC is a simulation-based training initiative to teach primary caregivers of infants being discharged from the NICU with tracheostomies and ventilators on how to manage airway emergencies. Developed a 4 hour training module that has been well received by families.

Next steps are to develop a multi-centered trial that can hopefully establish changes in actual patient care outcomes.

Randomized Trial of Continuous Capnography during Simulated Arrests

David Kessler

Columbia University

This study attempts to ascertain benefits to resuscitation management & potential patient outcomes with the addition of capnography monitoring.

Pending grant re-submission.

Improving Code Team Performance and Survival Outcomes: Implementation of Pediatric Composite Resuscitation Training

Knight L, Gabhart J.

Lucile Packard Children’s Hospital Stanford

This research examined the implementation of a composite resuscitation pediatric team training program that incorporated AHA PALS training, ongoing training of emergency equipment, code roles, institution specific code roles and responsibilities and in-situ unannounced mock codes to all interprofessional members of the pediatric Code team throughout the institution in which our pediatric team responded with the hypothesis that this training would improve code team performance and survival outcomes

Ongoing & supported within organization. Broadened to include; 1)Unit-based resus training; 2) Unannounced in-situ mock codes held twice monthly

Development of a Standardized Process for INSPIRE Procedure Kits

Marjorie White Taylor Sawyer

Alabama Children’s Hospital, Seattle Children’s Hospital

This is a secondary study that has become its own larger entity. It initially derived from the work of Dr. Kessler & Dr. Auerbach in their infant Lumbar Puncture procedure teaching kit, with validated checklists and training videos and methodologies. Now, Dr. White & Dr. Sawyer want to use the same validation processes to develop assessment & teaching kits for all procedures in pediatrics.

Manuscript accepted for publication in Academic Medicine. Continued development of validated checklists to be included into procedure kits.

Comparison of Endotracheal Intubation + Umbilical venous Catheter vs. Laryngeal Mask Airway + Intraosseous Needle in NRP

Byrne B, Wetzel E.

Indiana University

Study new NRP trainees in sim environment. Measured time and success to place an endotracheal tube and an UVC compared to placing an LMA and IO in a critically ill newborn in the delivery room.

Project Complete. Manuscript is in progress.

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Trauma Outreach Project

Chris Kennedy Ralph Mackinnon

University of Manchester, Children’s Mercy Hospital

The INSPIRE Pediatric Trauma Outreach project spans 3 continents and 5 countries, and aims to standardize and improve pediatric major trauma care.

Recruitment in progress.

Pediatric Simulation and the Milestones

Smith A. Develop cases around the ACGME Pediatrics Milestones. Correlate the evaluations of the sim cases with clinical evaluations and inservice exams.

Temporarily on hold. Reorganizing team.



Lead Institution

Description Current Status

Use of Epinephrine Auto injectors in the management of Anaphylaxis

DJ Scherzer Elizabeth Hunt Mindy Hamilton

Nationwide Children’s, Johns Hopkins University, Children’s Pittsburgh

Anaphylaxis is a potentially life threatening allergic reaction. Studies have shown that early identification and treatment improves outcome. However, anecdotal experience reveals prolonged time to administration of subcutaneous epinephrine and potentially life threatening errors in administration. This study is aimed at exploring whether the use of auto injectors will decrease the time to administration and decrease dosing errors for epinephrine.

Poster presentation at IPSSW 2015. Manuscript preparation in progress.

ImPACTS: Improving Pediatric Acute Care Through Simulation

Marc Auerbach

Yale University

ImPACTS is Improving Pediatric Acute Care through Simulation and is designed to assess and improve care for pediatric resuscitation in general Emergency Departments across the Northeast U.S.

Published 2 manuscripts, multiple other manuscripts in progress.

Handoff Assessment

Shilpa Hundalani


Utilizing simulated experiences the research team will develop a training curriculum, including a validated hand-off score tool that will teach pediatric residents how to consistently perform a standardized patient hand-off during a critical patient event.

In progress.

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Neonatal intubation group

Lindsay Johnston

Yale University

Neonatal intubation is a procedure performed in other to secure the airways of a child to assist in ventilation. This is usually performed through the mouth in neonates. This project attempts to design various educational interventions aimed at improving competence in neonatal intubation.

Completed literature & Delphi review. Draft checklist finalized. Working to assess validity evidence & reliability for checklist when used in simulated environment. Manuscript preparation in Fall 2015.

Lumbar Puncture

David Kessler Columbia University

Lumbar Puncture is used in the assessment of the febrile child in the assessment of Central Nervous System infection. This study has designed an educational intervention and is currently assessing the impact of this intervention on competency in performing a lumbar puncture among interns. This project seeks to improve outcomes with infant LP procedure through INSPIRE skills training package.

Complete. Working on manuscripts and grants for future work.

Script Concordance Testing in infant lumbar puncture

Todd Chang Children’s Hospital of LA

The decision to perform an infant lumbar puncture is often wrought with controversy given the nature of the procedure and the parental anxiety. Script concordance Testing is a method of assessing clinical decision making skills in situations of uncertainty. This study aims to define the most and least controversial scenarios involving infant LP according to attending physicians in a variety of pediatric fields.

Recruitment complete. Manuscript 1 published in Academic Medicine. Manuscript 2 accepted in Pediatric Emergency Care.

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Research Project Funding for INSPIRE Network Members from 2014-2015

Year Project and Funding Agency

2016-2021 Simulation-based Pediatric Research Collaborative (SPARC) Network for Trauma With: Dr. Vinay Nadkarni, Dr. Nancy Kassam-Adams, Children’s Hospital of Philadelphia *Applied for Funding to: National Institutes of Health, Child Health and Development Branch $3,750,000 USD

2015-2018 Consolidating tools for outcomes in resuscitation (CONTOUR) With: Dr. Dylan Bould (PI), Dr. Sylvain Boet (University of Ottawa), Dr. Farhan Bhanjji, Dr. Adam Cheng, Dr. Marc Auerbach, Dr. Linda Brown Funded By: Physicians’ Services Incorporated Foundation, $248,500 CAD

2015-2017 The Effect of a New Training Program on CPR Quality of Paediatric Healthcare Providers: A Randomized Trial with Economic Evaluation With: Dr. Adam Cheng (PI), Alberta Children’s Hospital and University of Calgary Funded By: The Royal College of Physicians and Surgeons of Canada, Medical Education on Research Grant $50,000 CAD

2015-2017 Teaching and Assessing Cost- and Time-effective Patient Care using Serious Gaming Strategies With: Dr. Todd Chang (PI), Children’s Hospital Los Angeles Funded by: Stemmler Fund, National Resident Matching Program $150,000 USD

2015-2017 Using leaderboards to improve CPR simulation practice among healthcare professionals With: Dr. Todd Chang (PI), Children’s Hospital Los Angeles Funded by: American Heart Association Western States Affiliates Grant-in-Aid $140,000 USD

2015-2017 Leaderboards for Improving CPR Training in Schools With: Dr. Ralph MacKinnon, Royal Manchester Children’s Hospital Funded By: Health England Research Grant $100,000 USD

2015-2016 Optimizing Integration of CPR Feedback Technology with CPR Coaching for Cardiac Arrest With: Dr. Adam Cheng (PI), Alberta Children’s Hospital and University of Calgary Funded By: Heart and Stroke Foundation of Alberta Seed Grant $45,000 CAD

2015-2016 Improving CPR Quality of Pediatric Healthcare Providers with Longitudinal Training and Real-Time CPR Feedback: A Randomized Trial with Economic Evaluation With: Dr. Adam Cheng (PI), Alberta Children’s Hospital and University of Calgary Funded By: Department of Pediatrics Innovation Grant $24,932 CAD

2015-2016 Pilot Evaluation of a Novel CPR Feedback Device in PICU: Can We Improve the Quality of CPR we Deliver to Patients? With: Dr. Adam Cheng (PI), Alberta Children’s Hospital and University of Calgary Funded By: Department of Pediatrics Innovation Grant $23,020 CAD

2015-2016 INSPIRE Network Training for Pediatric Emergency Care With: Dr. David Kessler (PI), Columbia University College of Physicians & Surgeons Funded by: RBaby Foundation $55,318 USD

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2014-2018 Assessing Simulation in Pediatrics: Improving Resuscitation Events: KidSIM-ASPIRE Simulation Research Program Infrastructure Grant With: Dr. Adam Cheng (PI), Alberta Children’s Hospital and Dr. Vincent Grant, University of Calgary Funded by: Alberta Children’s Hospital Research Institute, Alberta Children’s Hospital Foundation and Department of Pediatrics Research Grant $150,000

2014-2015 Improving CPR Quality and Cost Effectiveness with the American Heart Association’s Resuscitation Quality Improvement Program With: Dr. Jeffrey Lin (PI, PhD Candidate), Dr. Tyrone Donnon, Dr. Gillian Currie, University of Calgary, Dr. Vinay Nadkarni, Children’s Hospital of Philadelphia, Dr. Adam Cheng, Alberta Children’s Hospital Funded by: Laerdal Foundation for Acute Medicine $25,000 USD

2014-2015 ImPACTS: Improving Pediatric Acute Care Through Simulation With: Dr. Marc Auerbach (PI), Yale University. Site PIs include: Dr. Vinay Nadkarni (CHOP), Katz-Nelson (Hopkins), Mindy Fedlor-Hamilton (Pitt), Dr. David Kessler (Columbia), Dr. Linda Brown (Hasbro), Dr. Walsh (Umass), Dr. Gangadharan (Cohen’s/Hofstra) Funded by: RBaby Foundation $150,000 USD

2014-2015 Trauma Team and Leadership Simulation With: Dr. Todd Chang (Co-I), Children's Hospital Los Angeles Funded by: Children's Hospital Los Angeles Barbara Korsch Educational Grant $10,000 USD

2014 A fitness for purpose study of the Field Assessment Conditioning Tool (FACT development & outreach pilot study) With: Dr. Ralph MacKinnon, Chris Kennedy, Rachael Fleming, Catherine Doherty, Lambert Schuwirth & Terese Stenfors-Hayes, Royal Manchester Children’s Hospital $,10,000 (UK)

2014 A fitness for purpose study of the Field Assessment Conditioning Tool in NZ (FACT development & outreach pilot study) With: Dr. Ralph MacKinnon ,Dr Mike Shepherd, Dr Jo Cole, and Dr Chris Kennedy, Royal Manchester Children’s Hospital $10,000 (NZ)

2013-2015 A Virtual Pediatric Simulator (VPS) for Emergency Scenario Training of Military Medical Personnel With: Dr. James Gerard (PI), Anthony Scalzo (Co-PI) $541,807.00 USD

2013-2014 Procedural Skills Training in Pediatric Residency With: Dr. Zia Bismilla, Hospital for Sick Children, Feldman M, Amin H, Dubrowski A. Funded by: Hospital for Sick Children Paediatric Consultants Education Research Grant $4,085 CAD

2013-2014 Maximizing Summative and Formative Assessment in Simulation-Based Settings With: Dr. Adam Cheng (Co-I), Alberta Children’s Hospital and University of Calgary Funded By: The Royal College of Physicians and Surgeons of Canada Medical Education Research Grant $24,340 CAD

2013-2014 Validation study for simulating capillary refill in a mass-casualty simulation With: Dr. Todd Chang (PI), Children's Hospital Los Angeles Funded by: Southern California Clinical Translational Science Institute Research Pilot Fund $26,400 USD

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2013-2014 INSPIRE Network Infant Lumbar Puncture Competency Assessment With: Dr. Todd Chang (Sub-Contractor), Children's Hospital Los Angeles Funded by: RBaby Foundation $14,000 USD

2013-2014 ImPACTS: Improving Pediatric Acute Care Through Simulation With: Dr. Marc Auerbach (PI), Yale University Funded by: RBaby Foundation $300,000 USD Site PIs include: Dr. Vinay Nadkarni (CHOP), Katz-Nelson (Hopkins), Mindy Fedlor-Hamilton (Pitt), Dr. David Kessler (Columbia), Dr. Linda Brown (Hasbro), Dr. Walsh (Umass), Dr. Gangadharan (Cohen’s/Hofstra)

2012-2015 Advancing and Optimizing Quality of Resuscitation in Children with Cardiac Arrest With: Dr. Elizabeth A. Hunt (PI), Johns Hopkins University Funded by: The Hartwell Foundation $300,000 USD

2012-2014 CPR Training Using High-Fidelity Simulation and Train to Perfection in Medical Students With: Dr. Jonathan Duff (PI), University of Alberta, Dr. Carol Hodgson, University of Alberta, Dr. Farhan Bhanji, McGIll University, Dr. Adam Cheng, Alberta Children’s Hospital Funded by: Teaching and Learning Enhancement Fund, University of Alberta $18, 379 CAD

Abstracts (Poster, Oral), Workshops, Presentations

1. Auerbach M, Kessler DO, Patterson MD. The Use of In-Situ Simulation to Detect Latent Safety Threats in Pediatrics: A Cross-Sectional Survey. BMJ STEL In Press 2015

2. Braga MS, Tyler MD, Rhoads JM, Cacchio MP, Auerbach M, Nishisaki A, Larson RJ. The Effect of Just-in-Time Simulation Training on Provider Performance and Patient Outcomes for Clinical Procedures: A Systematic Review. BMJ STEL In Press 2015

3. Doughty C, Lemke D. Rapid Cycle Deliberate Practice Round Table Discussion. International Pediatric Simulation Society Symposia and Workshops, Vancouver, BC, May 2015.

4. McLaren S, Harwayne-Gidansky I, Critelli K, Garnett J, Ching K. Effectiveness of High Fidelity Simulation on Clinical Application of the PECARN Head Trauma Rule.Poster, Pediatric Academic Society (PAS) San Diego, CA 2015.

5. McLaren S, Harwayne-Gidansky I, Critelli K, Garnett J, Ching K. Effectiveness of High Fidelity Simulation on Clinical Application of the PECARN Head Trauma Rule. Platform: Eastern Society for Pediatric Research (ESPR) Philadelphia, PA 2015.

6. Harwayne-Gidansky, I., Ching, K., & Critelli, K. High-Fidelity Simulation Improves Resident Learning For The Pecarn Head Trauma Rule. Poster: Society for Critical Care Medicine Congress (SCCM) Phoenix, AZ 2015.

7. Duff, Bhanji, Lin, Overly, Brown, Charnovich, Kessler, Tofil, Hunt, Nadkarni, Cheng, INSPIRE CPR Investigators Quality of CPR within simulated cardiac arrest and influence of JIT training and feedback.

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Poster presentation at International Pediatric Simulation Society Meeting, Vancouver, 2015 8. Cheng A, Hunt EA, Grant D et al, for the INSPIRE CPR Investigators. Quality of CPR Provided

During Simulated Cardiac Arrest Across 9 Pediatric Institutions. International Pediatric Simulation Symposium and Workshops. Vancouver, Canada, May 2015

9. Cheng A, Overly F, Kessler D et al, for the INSPIRE CPR Investigators. Perception of CPR Quality: Influence of CPR Feedback, Just-in-Time CPR Training and Provider Role. International Pediatric Simulation Symposium and Workshops. Vancouver, Canada, May 2015

10. Brown L, Tofil N, Overly F, Lin Y, Duff J, Bhanji F, Nadkarni V, Hunt EA, Charnovich A, Kessler D, Bank I, Cheng A for the INSPIRE CPR Investigators. The Effect of a CPR Feedback Device on Provider Workload during a Simulated Pediatric Cardiac Arrest. International Pediatric Simulation Symposium and Workshops. Vancouver, Canada, May 4, 2015

11. Lin Y, Nadkarni V, Kissoon N, Currie G, Cheng A. Improved CPR Quality and Cost-Effectiveness with a New CPR Training Curriculum. International Pediatric Simulation Symposium and Workshops. Vancouver, Canada, May 4, 2015

12. Stoeter R, Doherty C, Fullwood C, Cheng A, Nadkarni V, Stenfors-Hayes T, Mackinnon R. Self-directed learning using an infant manikin improves and maintains infant CPR performance. International Pediatric Simulation Symposium and Workshops. Vancouver, Canada, May 4, 2015

13. Stoeter R, Doherty C, Fullwood C, Cheng A, Nadkarni V, Stenfors-Hayes T, Mackinnon R. Predictors of high quality CPR performance in the workplace on an infant manikin feedback device. International Pediatric Simulation Symposium and Workshops. Vancouver, Canada, May 4, 2015

14. Ruscica A, Kessler D. Impact of a Novel Card on Formative Feedback Provided To Residents in the Pediatric Emergency Department. Poster presentation at Pediatric Academic Society Meeting, San Diego, 2015

15. Auerbach, A. Comparing Pediatric Acute Care Delivery Across a Spectrum of Emergency Departments. Poster presentation at Pediatric Academic Society Meeting, San Diego, 2015

16. Xiao S, Nadkarni L, Ford B, Kessler D. Keepin' Time With "Stayin' Alive:" Assessing the Use of a Musical Mnemonic To Teach CPR Compression Rate. Poster presentation at the Pediatric Academic Society Meeting, San Diego, 2015 Poster presentation at Pediatric Research Day, Columbia University, 2015

17. Zaveri P, Kou M, Stryjewski G, Van Ittersum W, McAninch B, Auerbach M, Chang T, Kessler D

Improving Infant Lumbar Puncture Clinical Outcomes Among Novices. Poster presentation at the Pediatric Academic Society Meeting, San Diego, 2015

18. Cheng A, Brown L, Duff J, Davidson J, Overly F Tofil N, Peterson D, Whie M, Bhanji , Bank I, Gottesman R, Adler M, Zhong J, Grant V, Grant D, Sudikoff S, Marohn K, Charnovich A, Hunt E, Kessler D, Wong H, Robertson N, Lin J, Ouynh D, Nadkarni V. Improving CardioPulmonary Resuscitation with a CPR Feedback Device And Refresher Simulations (CPRCARES Study): A Multicenter, Randomized Trial. Oral presentation at the 15th Annual International Meeting on Simulation in Healthcare (IMSH), New Orleans, Louisiana, January, 2015 Best abstract Poster presentation, Royal College of Physicians and Surgeons Simulation Summit in Toronto, Canada. Best abstract Award.

19. Donoghue A, Brown L, Tofil N, Cheng A. Quantifying Clinical Performance during Simulated Pediatric Cardiac Arrest. International Meeting for Simulation in Healthcare, New Orleans, USA, Jan 10, 2015.

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20. Cheng A, Brown L, Duff J, Davidson J, Overly F, Tofil N, Peterson D, White M, Bhanji F, Bank I, Gottesman R, Adler M, Zhong J, Grant V, Grant D, Sudikoff S, Marohn K, Charnovich A, Hunt E, Kessler D, Wong H, Robertson N, Lin Y, Doan Q, Duval-Arnould J, Nadkarni V for the INSPIRE CPR Investigators. Improving CardioPulmonary Resuscitation with a CPR Feedback Device and Refresher Simulations (CPR CARES Study): A Multicenter,Randomized Trial. International Meeting for Simulation in Healthcare, New Orleans, USA, Jan 10, 2015

21. Auerbach, M. Mobile Outreach Simulation. Workshop at the 15th Annual International Meeting on Simulation in Healthcare (IMSH), New Orleans, Louisiana, January, 2015.

22. Thai, Sutton, Mclario, Cross, Warkentine, Wiedemann, Foster, Kessler, Horowitz, Abo, Cohen, Kim. Cost-effectiveness of Implementation of Point-of-care Ultrasound in a Pediatric Emergency Department. Oral presentation at SOEM, AAP, San Diego, California, October, 2014

23. Kessler D, Auerbach M, Fein D, Chang T, Lee M, Mehta R, Gerard J, Trainor J, Pusic M. Implementation and Impact of a Just-in-Time Assessment to Determine Intern Readiness to Perform Their First Infant Lumbar Puncture. Oral presentation at SOEM, AAP, San Diego, California, October, 2014 Poster presentation at the 15th Annual International Meeting on Simulation in Healthcare (IMSH), New Orleans, Louisiana, January, 2015

24. Cheng A, Brown L, Duff J, Davidson J, Overly F, Tofil N, Peterson D, White M, Bhanji F, Bank I, Gottesman R, Adler M, Zhong J, Grant V, Grant D, Sudikoff S, Marohn K, Charnovich A, Hnt E, Kessler D, Wong H, Robertson N, Lin Y, Doan Q, Duval-Arnould J, Nadkarni V for the INSPIRE CPR Investigators. Improving CardioPulmonary Resuscitation with a CPR Feedback Device and Refresher Simulations (CPR CARES Study): A Multicenter,Randomized Trial. Royal College of Physicians and Surgeons of Canada Simulation Summit, Toronto, Canada, Sept 11, 2014

Peer Reviewed Publications 2014-2015

1. Chime N, Katznelson J, Gangadharan S, Walsh B, Lobner K, Brown L, Gawel M, Auerbach MA. Comparing Practice Patterns between Pediatric and General Emergency Medicine Physicians: A Scoping Review. Pediatric Emergency Care. In Press 2015

2. Cheng A, Hunt EA, Grant D, Lin Y, Duff J, White ML, Peterson DT, Zhong J, Grant V, Gottesman R, Sudikoff S, Doan Q, Nadkarni V for the INSPIRE CPR Investigators. Variability in Quality of Chest Compressions Provided During Simulated Cardiac Arrest Across Nine Pediatric Institutions. Resuscitation, published Sept 25, 2015. doi: 10.1016/j.resuscitation.2015.08.024.

3. MacKinnon RJ, Stoeter R, Doherty C, Fullwood C, Cheng A, Nadkarni V, Stenfors-Hayes T, Chang TP. Self-motivated learning with gamification improves CPR performance, a randomised controlled trial. BMJ STEL, published Oct 6, 2015. doi:10.1136/bmjstel-2015-000061.

4. Kessler DO, Walsh B, Whitfill T, Gangaharan S, Gawel M, Brown L, Auerbach MA. Disparities in Adherence to Pediatric Sepsis Guidelines across a Spectrum of Emergency Departments: a multicenter, cross sectional observational in-situ simulation study. Journal of Emergency Medicine. E-publication September 2015.

5. Eppich W, Hunt EA, Duval-Arnould J, Siddall VJ, Cheng A. Structuring feedback and debriefing to achieve mastery learning goals. Academic Medicine, published Sept 11, 2015. doi: 10.1097/ACM.0000000000000934.

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6. Sawyer T, White M, Zaveri P, Chang TP, Ades A, French H, Anderson J, Auerbach M, Johnston L, Kessler D. Learn, See, Practice, Prove, Do, Maintain: An Evidence-based pedagogical Framework for Procedural Skill Training in Medicine. Academic Medicine 2015 ePub. PMID 25881645.

7. Auerbach, M, Chang T, Reid J, Quinones C, Krantz A, Pratt A, Gerard J, Mehta R, Pusic M, Kessler D. Are Pediatric Interns Prepared to Perform Infant Lumbar Punctures?: A Multi-Institutional Descriptive Study. Pediatric Emergency Care 29(4), 453-457.

8. Doughty C, Kessler D, Zuckerbraun N, Stone K, Reid J, Kennedy C, Nypaver M, Auerbach M. Simulation in Pediatric Emergency Fellowships. Pediatrics. 2015 Jun 8. pii: peds.2014-4158. [Epub ahead of print]

9. Cheng A, Grant V, Dieckmann P, Arora S, Robinson T, Eppich W. Faculty Development for Simulation Programs: 5 Issues for the Future of Debriefing Training. Simulation in Healthcare. 2015; 10(4):217-222.

10. Bank I, Cheng A, McLeod P, Bhanji F for the Pediatric Emergency Medicine Simulation Consensus Group. Determining Content for a Simulation-Based Curriculum in Pediatric Emergency Medicine: Results from a National Delphi Process. Canadian Journal of Emergency Medicine, Published online May 20, 2015, DOI: http://dx.doi.org/10.1017/cem.2015.11

11. Kessler D, Pusic MV, Chang TP, Fein DM, Grossman D, Mehta R, White M, Jang J, Whitfill T, Auerbach M; INSPIRE LP investigators. Impact of Just-in-Time and Just-in-Place Simulation on Intern Success with Infant Lumbar Puncture. Pediatrics 2015 May;135(5):e1237-46. PMID: 25869377.

12. Eppich W, Cheng A. How Cultural Activity Theory (CHAT) can Inform Debriefing of Inter-Professional Team Simulations. Clinical Simulation in Nursing. 2015; 11(8):383-389.

13. Shefrin A, Khazei A, Cheng A. Realism of Procedural Task Trainers in a Pediatric Emergency Medicine Procedures Course. Canadian Medical Education Journal. 2015; 6(1):e68-e73.

14. Cheng A, Lockey A, Bhanji F, Lin Y, Hunt EA, Lang E. The Use of High-Fidelity Manikins for Advanced Life Support Training – A Systematic Review and Meta-Analysis. Resuscitation. 2015; 93:142-9.

15. Lin Y, Cheng A. The Role of Simulation for Teaching Pediatric Resuscitation: Current Perspectives. Advances in Medical Education and Practice. 2015; 6:239-248.

16. Lee J, Cheng A, Allain D, Angelski C, Ali S. High Fidelity Simulation in Pediatric Emergency Medicine: A National Survey of Facilitator Comfort and Practice. Pediatric Emergency Care. 2015; 31(4):260-265.

17. Cheng A, Grant V, Auerbach M. Using Simulation to Improve Patient Safety: Dawn of a New Era. JAMA Pediatrics. 2015; 169(5):419-420.

18. Jones A, Lin Y, Nettel-Aguirre A, Gilfoyle E, Cheng A. Visual Assessment of CPR Quality During Pediatric Cardiac Arrest: Does Point of View Matter? Resuscitation. 2015; 90:50-55.

19. Eppich W, Cheng A. Promoting Excellence and Reflective Learning in Simulation (PEARLS): Development and Rationale for a Blended Approach to Health Care Simulation Debriefing. Simulation in Healthcare. 2015;10(2):106-115.

20. Cheng A, Palaganas J, Rudolph J, Eppich W, Robinson T, Grant VG. Co-Debriefing for Simulation-Based Education – A Primer for Facilitators. Simulation in Healthcare. 2015;10(2):69-75.

http://dx.doi.org/10.1017/cem.2015.11

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21. Cheng A, Donoghue A, Bhanji F. Incorporating Real-Time CPR Feedback and Quantitative CPR Debriefings into Advanced Life Support Courses: Luxury or Necessity? Resuscitation. 2015; 90:e3-e4.

22. Eppich W, Cheng A. Competency-Based Simulation Education: Should Competency Standards Apply to Simulation Educators? BMJ Simulation and Technology Enhanced Learning. 2015; 1:3-4.

23. Cheng A, Overly F, Kessler D, Nadkarni V, Lin Y, Doan Q, Duff J, Tofil N, Bhanji F, Adler M, Charnovich A, Hunt E, Brown L, for the International Network for Simulation-based Pediatric Innovation, Research, Education (INSPIRE) CPR Investigators, Perception of CPR quality: Influence of CPR feedback, Just-in-Time CPR training and provider role. Resuscitation 201, (87), 44-50, February 2015.

24. Cheng A, Brown LL, Duff JP, Davidson J, Overly F, Tofil NM, Peterson DT, White ML, Bhanji F, Bank I, Gottesman R, Adler M, Zhong J, Grant V, Grant DJ, Sudikoff ST, Marohn K, Charnovich A, Hunt EA, Kessler DO, Wong H, Robertson N, Lin Y, Doan Q, Duval-Arnould JM, Nadkarni VM; for the International Network for Simulation-Based Pediatric Innovation, Research, & Education (INSPIRE) CPR Investigators: Improving cardiopulmonary resuscitation with a CPR feedback device and refresher simulations (CPR CARES Study). JAMA Pediatrics 169(2): 137-144, February 2015.

25. Chang TP, Kwan KY, Liberman D, Song E, Dao EH, Chung D, Morton I, Festekjian A. Introducing Teamwork Challenges in Simulation Using Game Cards. Simul Healthc 2015 ePub. PMID: 25932705.

26. Doughty C, Welch-Horan T, Hsu D, Fielder E, Pereira F, Little-Wienert K, Kaziny B, McManemy J, Lemke D. Rapid Cycle Deliberate Practice Pediatric Simulation Scenarios. MedEdPORTAL Publications; 2015. Available from: https://www.mededportal.org/publication/10134http://dx.doi.org/10.15766/mep_2374-8265.10134

27. Knight, L, Gabhart, J, Earnest, K et al. (2014): “Improving Code Team Performance and Patient Survival Outcomes: Implementation of Composite Resuscitation Team Training.” Critical Care Medicine, 40 (2), 246-258.

28. Braun C, Kessler D, Auerbach M, Mehta R, Scalzo A, Gerard J. "Can Residents Assess Other Providers' Infant Lumbar Puncture Skills? Validity Evidence for a Global Rating Scale and Subcomponent Skills Checklist". Pediatric Emerg Care. Accepted November 2014.

29. Tiyyagura G, Balmer D, Chaudoin L, Kessler D, Khanna K, Srivastava G, Chang T, Auerbach M. "The Greater Good: How Supervising Physicians Make Entrustment Decisions in the Pediatric Emergency Department." Academic pediatrics 14, no. 6 (2014): 597-602.The Greater Good: How Supervising Physicians Make Entrustment Decisions in the Pediatric Emergency Department. Academic pediatrics, 14(6), 597-602.

30. Cheng A, Raemer DB. Is Clinical Trial Registration for Simulation-Based Research Necessary? Simulation in Healthcare. 2014;9(6):350-352.

31. Mullan P, Kessler D, Cheng A. Educational Opportunities with Postevent Debriefing. The Journal of the American Medical Association. 2014;312(22):2333-2334.

32. Kessler D, Mullan P, Cheng A. Debriefing in the Emergency Department after Clinical Events: A Practical Guide. Annals of Emergency Medicine. 2014; 65(6):690-698.

33. Qayumi K, Pachev G, Zheng B, Ziv A, Koval V, Badiei S, Cheng A. Status of Simulation in Healthcare Education: An International Survey. Advances in Medical Education and Practice. 2014;28(5):457-467.

https://www.mededportal.org/publication/10134

https://www.mededportal.org/publication/10134

http://dx.doi.org/10.15766/mep_2374-8265.10134

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34. Cheng A, Eppich W, Grant V, Sherbino J, Zendejas-Mummert B, Cook D. Debriefing for Technology-Enhanced Simulation: A Systematic Review and Meta-Analysis. Medical Education. 2014;48(7):657-666.

35. Cheng A, Auerbach M, Chang T, Hunt EA, Pusic M, Nadkarni V, Kessler D. Designing and Conducting Simulation-based Research. Pediatrics. 2014; 133(6): 1091-1101.

36. Cheng A, Lang T, Starr S, Pusic M, Cook D. Technology-Enhanced Simulation and Pediatric Education: A Meta-Analysis. Pediatrics. 2014;133(5):e1313-e1323.